Reduced Multidrug Susceptibility Profile Is a Common Feature of Opportunistic Fusarium Species: Fusarium Multi-Drug Resistant Pattern

Overview

Journal J Fungi (Basel)

Date 2018 Jan 27

PMID 29371536

Citations 15

Authors

Saad J Taj-Aldeen

Affiliations

Soon will be listed here.

Abstract

The resistance among various opportunistic species to different antifungal agents has emerged as a cause of public health problems worldwide. Considering the significance of multi-drug resistant (MDR), this paper emphasizes the problems associated with MDR and the need to understand its clinical significance to combat microbial infections. The search platform PubMed/MEDLINE and a review of 32 cases revealed a common multidrug-resistant profile exists, and clinically relevant members of are intrinsically resistant to most currently used antifungals. Dissemination occurs in patients with prolonged neutropenia, immune deficiency, and especially hematological malignancies. Amphotericin B displayed the lowest minimum inhibitory concentrarions (MICs) followed by voriconazole, and posaconazole. Itraconazole and fluconazole showed high MIC values, displaying in vitro resistance. Echinocandins showed the highest MIC values. Seven out of ten (70%) patients with neutropenia died, including those with fungemia that progressed to skin lesions. Clinical isolates displayed a common MDR profile and high MIC values for the most available antifungal agents with species- and strain-specific differences in antifungal susceptibility. Species identification of infections is important. While the use of natamycin resulted in a favorable outcome in keratitis, AmB and VRC are the most used agents for the treatment of fusariosis in clinical settings.

Citing Articles

Fusarium species,Scedosporium species, and Lomentospora prolificans: A systematic review to inform the World Health Organization priority list of fungal pathogens.

Marinelli T, Kim H, Halliday C, Garnham K, Bupha-Intr O, Dao A Med Mycol. 2024; 62(6).

PMID: 38935914 PMC: 11210614. DOI: 10.1093/mmy/myad128.

The Addition of Systemic Terbinafine to Antifungal Combination Therapy in the Treatment of Disseminated Drug-Resistant Mold Infections in a National Cancer Institute Comprehensive Cancer Center: A Six-Year Study.

Thomas Jr D, Ajayi E, Sikora A, Cozzini L, Quilitz R, Pasikhova Y Cureus. 2024; 16(3):e55343.

PMID: 38559513 PMC: 10981918. DOI: 10.7759/cureus.55343.

Antifungal metabolites, their novel sources, and targets to combat drug resistance.

Choudhary M, Kumar V, Naik B, Verma A, Saris P, Kumar V Front Microbiol. 2022; 13:1061603.

PMID: 36532457 PMC: 9755354. DOI: 10.3389/fmicb.2022.1061603.

In Vitro Antifungal Susceptibility Profile of Miltefosine against a Collection of Azole and Echinocandins Resistant Strains.

Nosratabadi M, Akhtari J, Faeli L, Haghani I, Aghili S, Shokohi T J Fungi (Basel). 2022; 8(7).

PMID: 35887464 PMC: 9315751. DOI: 10.3390/jof8070709.

A chloroacetamide derivative as a potent candidate for fusariosis treatment.

da Rosa Monte Machado G, Lavorato S, Lopes W, Vainstein M, Lettieri Teixeira M, Alves R Braz J Microbiol. 2022; 53(3):1289-1295.

PMID: 35648381 PMC: 9433475. DOI: 10.1007/s42770-022-00771-9.

References

Bhartiya P, Daniell M, Constantinou M, Islam F, Taylor H . Fungal keratitis in Melbourne. Clin Exp Ophthalmol. 2007; 35(2):124-30. DOI: 10.1111/j.1442-9071.2006.01405.x. View

Donnelley M, Zhu E, Thompson 3rd G . Isavuconazole in the treatment of invasive aspergillosis and mucormycosis infections. Infect Drug Resist. 2016; 9:79-86. PMC: 4898026. DOI: 10.2147/IDR.S81416. View

Al-Hatmi A, van Diepeningen A, Curfs-Breuker I, de Hoog G, Meis J . Specific antifungal susceptibility profiles of opportunists in the Fusarium fujikuroi complex. J Antimicrob Chemother. 2014; 70(4):1068-71. DOI: 10.1093/jac/dku505. View

Loeffler J, Stevens D . Antifungal drug resistance. Clin Infect Dis. 2003; 36(Suppl 1):S31-41. DOI: 10.1086/344658. View

Antunes N, Hariharan S, DeAngelis L . Brain abscesses in children with cancer. Med Pediatr Oncol. 1998; 31(1):19-21. DOI: 10.1002/(sici)1096-911x(199807)31:1<19::aid-mpo4>3.0.co;2-2. View

Thomas P . Current perspectives on ophthalmic mycoses. Clin Microbiol Rev. 2003; 16(4):730-97. PMC: 207127. DOI: 10.1128/CMR.16.4.730-797.2003. View

Anaissie E, Kuchar R, Rex J, Francesconi A, Kasai M, Muller F . Fusariosis associated with pathogenic fusarium species colonization of a hospital water system: a new paradigm for the epidemiology of opportunistic mold infections. Clin Infect Dis. 2001; 33(11):1871-8. DOI: 10.1086/324501. View

De Pauw B, Walsh T, Donnelly J, Stevens D, Edwards J, Calandra T . Revised definitions of invasive fungal disease from the European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group.... Clin Infect Dis. 2008; 46(12):1813-21. PMC: 2671227. DOI: 10.1086/588660. View

Jensen T, Gahrn-Hansen B, Arendrup M, Bruun B . Fusarium fungaemia in immunocompromised patients. Clin Microbiol Infect. 2004; 10(6):499-501. DOI: 10.1111/j.1469-0691.2004.00859.x. View

10.

Nucci M, Anaissie E, Queiroz-Telles F, Martins C, Trabasso P, Solza C . Outcome predictors of 84 patients with hematologic malignancies and Fusarium infection. Cancer. 2003; 98(2):315-9. DOI: 10.1002/cncr.11510. View

11.

Liu J, Chen W, Ko B, Yao M, Hsueh P, Hsiao C . Combination antifungal therapy for disseminated fusariosis in immunocompromised patients : a case report and literature review. Med Mycol. 2011; 49(8):872-8. DOI: 10.3109/13693786.2011.567304. View

12.

Sara S, Sharpe K, Morris S . Multidrug-resistant Fusarium keratitis: diagnosis and treatment considerations. BMJ Case Rep. 2016; 2016. PMC: 4986156. DOI: 10.1136/bcr-2016-215401. View

13.

Nucci M, Anaissie E . Fusarium infections in immunocompromised patients. Clin Microbiol Rev. 2007; 20(4):695-704. PMC: 2176050. DOI: 10.1128/CMR.00014-07. View

14.

Espinel-Ingroff A, Colombo A, Cordoba S, Dufresne P, Fuller J, Ghannoum M . International Evaluation of MIC Distributions and Epidemiological Cutoff Value (ECV) Definitions for Fusarium Species Identified by Molecular Methods for the CLSI Broth Microdilution Method. Antimicrob Agents Chemother. 2015; 60(2):1079-84. PMC: 4750715. DOI: 10.1128/AAC.02456-15. View

15.

Cho C, Vats T, LOWMAN J, BRANDSBERG J, TOSH F . Fusarium solani infection during treatment for acute leukemia. J Pediatr. 1973; 83(6):1028-31. DOI: 10.1016/s0022-3476(73)80543-8. View

16.

Kandeel A, Abu-Elmagd K, Spinner M, Khanna A, Hashimoto K, Fujiki M . Atypical Clinical Presentation of a Newer Generation Anti-Fungal Drug-Resistant Fusarium Infection After a Modified Multi-Visceral Transplant. Ann Transplant. 2015; 20:512-8. DOI: 10.12659/AOT.892209. View

17.

Ricna D, Lengerova M, Palackova M, Hadrabova M, Kocmanova I, Weinbergerova B . Disseminated fusariosis by Fusarium proliferatum in a patient with aplastic anaemia receiving primary posaconazole prophylaxis - case report and review of the literature. Mycoses. 2015; 59(1):48-55. DOI: 10.1111/myc.12421. View

18.

Arrese J, Pierard-Franchimont C, Pierard G . Fatal hyalohyphomycosis following Fusarium onychomycosis in an immunocompromised patient. Am J Dermatopathol. 1996; 18(2):196-8. DOI: 10.1097/00000372-199604000-00014. View

19.

Gupta C, Jongman M, Das S, Snehaa K, Bhattacharya S, Seyedmousavi S . Genotyping and In Vitro Antifungal Susceptibility Testing of Fusarium Isolates from Onychomycosis in India. Mycopathologia. 2016; 181(7-8):497-504. DOI: 10.1007/s11046-016-0014-7. View

20.

Sekeroglu H, Erdem E, Yagmur M, Gumral R, Ersoz R, Ilkit M . Successful medical management of recalcitrant Fusarium solani keratitis: molecular identification and susceptibility patterns. Mycopathologia. 2012; 174(3):233-7. DOI: 10.1007/s11046-012-9542-y. View